Economic burden of caring for Pediatric Tuberculosis patients among households in Jinja District, Uganda: a cross-sectional study

Economic burden of caring for Pediatric Tuberculosis patients among households in Jinja District, Uganda: a cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Economic burden of caring for Pediatric Tuberculosis patients among households in Jinja District, Uganda: a cross-sectional study Paul Mukama Ategyeka, Christopher Tumusiime, Michael Muhoozi, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9040952/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Introduction Tuberculosis (TB) is an important source of economic devastation, revolving poverty, and illness. It has ensnared families, societies, and even countries globally, with the most vulnerable groups being women, children, and HIV patients. The economic burden of the disease is likely to increase among pediatric TB patients because it affects caregivers. Therefore, we assessed the economic burden faced by households with pediatric and adolescent TB patients aged 0 to 19 years in Jinja district. Methods We used an incidence-based, ingredient-based approach to estimate societal and household costs which included out-of-pocket costs and lost income incurred during pediatric TB treatment. Catastrophic health expenditures (CHE) were calculated based on the percentage of income spent on TB care among 324 caregivers of pediatric and adolescent TB patients aged 0–19 years (1st July, 2023 to 30th June, 2024). We used proportionate to size and systematic sampling. Descriptive analysis was used to determine the CHE if it spent more than the following thresholds on pediatric TB management: 10% of its income, 20% of its monthly expenditures or 40% of its monthly expenditures without food. Results Out of 324 caregivers, 74.1% were women and 34.0% participants aged 30–39 years. While TB drugs were provided for free, caregivers incurred an average cost of US $ 1.42 for diagnosis, US $ 0.57 for hospitalization, US $ 2.49 for travel, and US $ 1.36 for food during treatment. The overall mean cost of TB care per caregiver was US $ 4.10 excluding food, and US $ 5.33 with food. In addition to direct costs, caregivers also experienced productivity losses, with a median cost of US $ 12.97. CHE was experienced by 43.5% households at the 10% income threshold, decreasing to 22.5% and 18.2% at the 25% and 40% thresholds, respectively. Conclusion While TB medicines were free at governmental facilities, half of the families caring for children with TB experienced CHE. This increased economic burden on the already financially vulnerable families. Therefore, there is need for social support systems for the caregivers such as offering them with food vouchers. Pediatric-TB Catastrophic health expenditure Productivity losses Costs Introduction Tuberculosis (TB) is a major public health concern that mainly affects the poorest individuals [ 1 ]. In 2022, an estimated 1.3 million children were diagnosed with TB disease globally [ 2 ]. Uganda is among the high-burden TB countries (ref). Of the total TB cases detected in Uganda, 15% are among children aged 14 years and below[ 3 ]. TB is an important source of economic devastation, revolving poverty and illness, which has ensnared families, societies, and even countries globally, with the most vulnerable groups being women, children, and HIV patients [ 4 – 6 ]. Despite TB services being free in most developing countries, patients and caregivers still face catastrophic costs that reduce their income and push them into poverty. Treatment and taking care of pediatric TB patients increases a family’s expenditure leading to catastrophic costs. The World Health Organization (WHO) reported that 48% of people with TB faced catastrophic costs in 2022 [ 7 ]. Previous studies focusing on adults diagnosed with TB found that 53.1% households in Uganda spent more than 20% of their household income on TB management [ 8 ]. The WHO defines catastrophic costs due to TB as costs that exceed 20% of the annual household income [ 9 ]. These may be related to indirect costs such as income loss related to time lost from work or loss of employment in addition to direct costs [ 10 ]. In sub-Saharan Africa, TB patients and their households often incur high costs when utilizing TB treatment and care [ 10 , 11 ]. TB treatment and care-related costs were considered to be catastrophic because the patient costs incurred usually amounted to 10% or more of per capita incomes especially in the East African countries [ 11 ]. Catastrophic costs due to TB pose a great challenge in achieving “The End TB strategy” which aims at protecting households from catastrophic costs due to TB to 100% by 2025 [ 9 ]. The burden posed by the costs and the coping strategies adopted by the families determines the level of impoverishment [ 12 ]. The economic burden of TB is likely higher among pediatric and adolescent TB patients because it also affects the caregivers such as parents or guardians who have to take off time from work to nurse their children [ 11 ]. There are also increased out-of-pocket medical expenses and lost income due to the illness [ 13 ]. TB diagnosis among children utilizes methods such as chest X-rays, for clinical confirmation [ 14 ], aspiration of gastric fluid and suctioning following sputum induction (IS) which are costly [ 15 ]. Many families face catastrophic costs due to TB in addition to their earning low income [ 13 , 16 ]. These factors can affect adherence to TB treatment leading to poor outcomes such as drug resistance or even death. The financial cost of pediatric tuberculosis (TB) is a noteworthy problem that has not received much attention with more attention on adult TB patients. The socioeconomic effects of tuberculosis (TB), both directly and indirectly, as household members or caregivers or as children and adolescents impacted by the disease [ 17 ] is not well understood. This study therefore assessed the economic burden faced by households with pediatric and adolescent TB patients aged 0 to 19 years in Jinja district in Uganda. Methods Study Design This was a cross-sectional study, where data were collected at a single point in time. The expenditures and resource usage related to pediatric and adolescent TB treatment and care, as well as related activities, were collected retrospectively. The cost of treating and caring for a pediatric and adolescent TB patient and the productivity loss resulting from it were estimated from the viewpoints of the care-givers using an incidence-based costing technique combined with an ingredient-based approach. Study Setting The study was conducted in Jinja, a district in the Southeastern Uganda. Jinja district had a TB incidence rate of 292/100,000 in 2017, higher than the Uganda national average of 201/100,000 [ 18 , 19 ]. The district is subdivided into three counties namely, Butembe, Kagoma and Jinja Municipality as well as six sub-Counties, 46 parishes and 381 villages. Economically, Jinja is majorly an industrial city hosting several agricultural, fish processing, construction and mining and quarrying industries [ 20 ]. The district has several public and private-not-for-profit (PNFP) health facilities that provide TB services where data were collected. These included Jinja regional referral hospital, AIDS Information Center (AIC)- Jinja, Bugembe HCIII, Family Hope-Jinja, Mpumudde HCIII, ST. Benedict HC IV, and Walukuba HCIII. We included these facilities because they were diagnostic TB units that had a GeneXpert machine. Study population The study was conducted among pediatric and adolescent TB patients aged 0–19 years who were receiving treatment at different levels of care (TB diagnostic and treatment units) in Jinja district during the period,1st July, 2023 to 30th June, 2024. Interviews were conducted among caregivers of eligible children and adolescents selected to participate in the study. Sample size This study was an incidence-based household survey that estimated the economic burden of pediatric and adolescent TB. Using the Kish–Leslie formula for cross-sectional studies with the assumptions of p = 15% (reference), z = 1.96 and precision, σ, of 5%, we estimated a sample size of 324 respondents after adjusting for a 10% non-response. Sampling procedure At each selected facility, systematic sampling was used to select pediatric and adolescent TB patients whose caregivers participated in the survey. To achieve this, a list of eligible TB patients was made and organized according to date of registration of the patients for each facility for the period of 1st July, 2023 to 30th June, 2024. Then the n th patient was selected to participate in this study. The desired sample size for each facility was determined by (the number of Ped TB patients at each facility/ Total number of all the ped-TB patients in the seven health facilities) multiplied by the sample size (324 ped-TB Patients). This was determined by sampling interval (n th ) = Total number of patients in the sampling frame (at each facility) / desired sample size for each facility using proportionate to size. A list of selected patients aged 0–19 years was generated, it included the patients’ information, their next of kin (primary caregiver) with their telephone numbers and address. The interviews were conducted from the patients’ homes as most were unreachable through the available telephone contacts. The research assistants with the support of the village health teams (VHTs) and Community Linkage Facilitators (CLFs) attached to the facility tracked patients to their homes as most of them received TB diagnosis and treatment from their homes. We didn’t include pediatric and adolescent TB patients whose outcome was transfer ins (these patients that were registered and start TB treatment from one TB unit and later are transferred to another facility). This was done to prevent double counting during selection of the participants. Data collection We collected data using a survey tool from WHO called the Tuberculosis patient cost surveys: a handbook, 2017 that captured information on household costs and expenditures for pediatric TB patients [ 21 ]. The study tools were pretested to ensure clarity, suitability and logical flow of questions and were revised before being used in the field. The tools were pre-tested at a non-participating community in Buikwe district. The questionnaire was administered to caregivers of the Ped-TB patients. The costing tool was designed to capture household income, expenditure and out-of-pocket payments incurred due to the disease. Caregivers were interviewed to gather household and patient’s costs (in case they incurred the costs). Costs borne directly by the TB patient were solicited from the caregivers of pediatric TB patients. Information of those who died due to TB was acquired from the main caregiver. The survey tool also helped to collect and capture household income and expenditure and also out-of-pocket payments incurred due to the disease. The study questionnaire was translated into Lusoga, the commonly spoken language in Jinja, and interviews were conducted in the same language. Data collection were conducted by trained research assistants with experience in conducting costing studies and interviews who underwent a five-day training in preparation for the exercise. Variables: Outcome variables This study had three outcome variables namely Costs incurred due to Ped-TB treatment, Productivity loss due to TB and Catastrophic health expenditures (CHE): Costs incurred due to pediatric TB treatment – This was determined using a questionnaire where the care givers were asked questions regarding how much they spent while taking care of the pediatric TB patients for a period of three to six months for drug-susceptible patients and 12 to 24 months for MDR-TB patients. These costs were categorized by TB status (susceptible TB and MDR-TB) and then the average costs presented for each. Productivity loss due to TB – This was determined using the questionnaire where the care givers were asked questions regarding how much time they took off from their work to look after the pediatric TB patient. The time was apportioned by TB status (susceptible TB and MDR-TB) and then the average productivity loss due to TB was presented for each. Catastrophic health expenditures (CHE) CHE was calculated using direct and indirect costs that is the annual income minus expenditures for the households. Data collected on expenditures comprised of food, clothing, supplies, leisure, tax paid, other healthcare expenses and other expenses including going to traditional herbalists and healers. Independent variables The independent variables included: sex, age, distance to the facility, wealth index, number of household members, TB characteristics such as type of TB, TB classification, and average income of the household . Data management and analysis Costing approaches The study determined societal costs using a combination of the costs borne by the caregivers of pediatric TB patients and those by the healthcare system. Differences within direct and indirect costs for TB treatment and care, and socio-economic status, service provider status, age, sex and residence were tested using relevant statistical tests such as rank sum test. In this study, principal component analysis (PCA) approach was used to score assets; which was ranked to determine wealth quintiles [ 22 ]. Catastrophic health expenditures (CHE) A household experienced catastrophic health expenditures if it spent more than the following thresholds on pediatric TB management: 10% of its income, 20% of its monthly expenditures or 40% of its monthly expenditures without food [ 23 ]. Results Socio-economic characteristics of participants Of the 324 participants, the majority were female (74.1%), with an average age of 38 years (SD 13.4), where 30–39 years was the most predominant age group (34.0%). A half (50.0%) of the participants had only primary education and over 60% were married. Caregivers were mainly mothers (44.8%) and four in ten (40.1%) belonged to the poorer wealth index category (Table 1 ). Table 1 Social-economic characteristics of caregivers of Ped-TB patients in Jinja Variables Frequency (%) Age of participant 15-19yrs 9 (2.8) 20-29yrs 87 (26.9) 30-39yrs 110 (34.0) 40-44yrs 54 (16.7) 50-59yrs 33 (10.2) 60 + yrs 31 (9.6) Average age of participants (Standard deviation) 38 (± 13.4) Age of the child (TB patient) 0–4 yrs 59 (18.2) 5-9yrs 126 (38.9) 10-14yrs 90 (27.8) 15-19yrs 49 (15.1) Average age of child (Standard deviation (SD)) 9 years (± 4.7) Sex of study participant Female 240 (74.1) Male 84 (25.9) Sex of TB patient Female 156 (48.1) Male 168 (51.9) Religion Anglican 96 (29.6) Born-Again/ Pentecostal 57 (17.6) Catholic 92 (28.4) Muslim 73 (22.5) SDA 6 (1.9%) Highest level of education None at all 27 (8.3) Primary level 162 (50.0) Secondary level 105 (32.4) Tertiary 30 (9.3) Child attending school No 97 (29.9) Yes 227 (70.1) Marital status Married 199 (61.4) Separated/ Divorced or Widowed 96 (29.6) Single and never in a Union 29 (9.0) Employment status Unemployed 87 (26.9) Full time work 58 (17.9) Part time work 53 (16.4) Student 12 (3.7) Others 114 (35.2) Relationship with the Pediatric TB patient Father 44 (13.6) Mother 145 (44.8) Sister/ Brother 44 (13.6) Others (family relatives, friends) 91 (28.1) Number of adult household members 1–2 Household members 201 (62.0) 3–4 Household members 92 (28.4) 5 and above HH members 31 (9.6) Number of children in household 1–2 children 95 (29.3) 3–4 children 114 (35.2) 5–6 children 82 (25.3) 7 & more children 33 (10.2) Overall number of household members less than 5 members 79 (24.4) 5–9 members 199 (61.4) 10 + members 46 (14.2) Wealth index Poorer 130 (40.1) Moderate 66 (20.4) Slightly Rich 128 (39.5) Percentages use the full analysis sample (N = 324); categories may not sum to N due to missing values. Mean age is presented as mean (SD). The household wealth index was derived via principal component analysis of assets and grouped for presentation. SD, standard deviation; IQR, interquartile range. Access to care and TB status among pediatric TB patients From Table 2 , most pediatric TB patients in Jinja were receiving care from Jinja Regional Referral Hospital (33.0%) and Health Centre III facilities (46.0%), with most facilities being public (53.4%). Pulmonary bacteriologically confirmed TB (P-BC) was the most common diagnostic approach (81.8%), and nearly all patients had drug-susceptible TB (93.5%). Patients with newly diagnosed TB cases were 99.7%. Most children were HIV-negative (94.1%) and had completed treatment (71.9%), while only a few were currently hospitalized (3.3%) or had been hospitalized previously (12.4%). Community-based directly observed treatment (DOT) (50.6%) was most common, followed by self-administered treatment (39.2%). The majority of caregivers picked up drugs regularly from the TB units (Jinja RRH, AIC- Jinja, Bugembe HCIII, Family Hope-Jinja, Mpumudde HCIII, ST. Benedict HC IV, and Walukuba HCIII) (88.2%) and only a very small fraction reported using traditional healers (2.2%). Table 2 Showing social- economic factors of caregivers of Ped-TB patients in Jinja Variables Frequency (%) Health facility AIC Jinja 63 (19.4) Bugembe 25 (7.7) Family Hope Jinja 48 (14.8) Jinja RRH 107 (33.0) Mpumudde 5 (1.5) ST. Benedict 60 (18.5) Walukuba 16 (4.9) Level of care of the facility HC III 149 (46.0) HC IV 44 (13.6) General Hospital 26 (8.0) RRH 105 (32.4) Type of facility Private by not for Profit 151 (46.6) Public 173 (53.4) The type of TB diagnosis Extra-Pulmonary-TB 1 (0.3) Pulmonary-Bacteriologically Confirmed 265 (81.8) Pulmonary-Clinically Diagnosed 58 (17.9) The type of TB disease DS-TB 303 (93.5) MDR-TB 21 (6.5) The type of TB case Newly diagnosed TB case 323 (99.7) Re-treatment case 1 (0.3) HIV status of the child Negative 305 (94.1) Positive 13 (4.0) Unknown 6 (1.9) The phase of TB treatment Completed treatment 233 (71.9) Continuous phase 58 (17.9) Intensive Phase 33 (10.2) Patient currently hospitalized No 88 (96.7) Yes 3 (3.3) Patient was previously hospitalized No 204 (87.6) Yes 29 (12.4) DOT used CB DOT 164 (50.6) FB DOT 33 (10.2) Self-administered 127 (39.2) Pick up of TB drugs No 15 (11.8) Yes 112 (88.2) Used traditional healers No 317 (97.8) Yes 7 (2.2) Facility levels: HC III/HC IV, Health Centre Levels III/IV; RRH, Regional Referral Hospital; PNFP, Private Not‑for‑Profit. TB types: P‑BC, pulmonary bacteriologically confirmed; P‑CD, pulmonary clinically diagnosed; EPTB, extra‑pulmonary TB; DS‑TB, drug‑susceptible TB; MDR‑TB, multidrug‑resistant TB. DOT models: CB DOT, community‑based DOT; FB DOT, facility‑based DOT. HIV, human immunodeficiency virus; AIC, AIDS Information Center Estimated costs incurred during treatment of pediatric TB patients among caregivers of households in Jinja. TB drugs were provided at no cost at the government facilities where most caregivers obtained them. However, caregivers incurred an average of US $ 1.4 mainly on diagnosis. On average, hospitalization costs were US $ 0.6 while out-of-pocket expense for travel to seek medical care, was US $ 2.5. The average cost of meals and food-related costs during treatment was US $ 1.4. Overall, the average total medical cost excluding food was US $ 4.1, and US $ 5.3 when food is included (Table 3 ). Table 3 Average costs incurred during Pediatric TB management by the care giver Costs Mean (US $ ) Std Deviation (± US $ ) TB-Drug related costs 0 0 Diagnosis costs 1.4 10.4 Hospitalization costs 0.6 6.7 Travel cost to the facility 2.5 4.4 Meals and foods costs during TB treatment 1.4 5.3 Medical costs without food inclusive 4.1 16.3 Medical costs with food 5.3 18.2 All costs were collected in Ugandan shillings (UGX) and converted to [2024] US dollars (US $ ) using an average exchange rate of [UGX. 3600] [ 24 ]. Costs refer to the treatment episode unless otherwise noted.; means (SD) are provided for comparability. Estimated productivity losses for caregivers of households with pediatric TB patients (0 to 19 years) in Jinja. Table 4 shows that caregivers experienced a reduction in daily working hours after a pediatric TB diagnosis, with the median daily hours worked dropping from 10 to 7 hours. During the initial diagnosis and treatment phase, caregivers spent a median of 4 hours (IQR: 4), reflecting significant time investment. Follow-up reviews required less time but still varied, with the first and second reviews each taking a median of 1 hour and the final post-treatment review taking 2 hours. Table 4 Median time spent by the caregiver in getting TB treatment for his child Number of hours worked on a daily basis before pediatric TB Median time (hours) 25th percentile 75th percentile IQR 10 7 12 5 Number of hours worked on a daily basis after pediatric TB diagnosis 7 5 9 4 Number of hours spent during initial diagnosis and TB treatment 4 2 6 4 Number of hours spent during 1st review (month 2 of DS-TB treatment) 1 0.25 3 2.75 Number of hours spent during 2nd review (month 5 of DS-TB treatment) 1 0.5 3 2.5 Number of hours spent during 3rd review (post treatment review of DS-TB treatment) 2 1 4 3 Time includes travel, waiting, and consultation unless specified. Review visits correspond to DS‑TB months 2 and 5, and post‑treatment review At the time of diagnosis, the median productivity loss was US $ 5.4, with an interquartile range (IQR) of US $ 16.2. Productivity losses decreased on subsequent visits, US $ 0.8, US $ 1.4, and 2.7 at visits 2, 3, and 4 respectively. The overall median productivity loss incurred during the course of TB management was US $ 13.0, with an IQR of US $ 39.4 (seen in Table 5 ). Table 5 Average productivity losses incurred during Pediatric TB management by the caregiver Productivity losses Median (US $ ) 25% - Percentiles (US $ ) 75% - Percentiles (US $ ) IQR (US $ ) Productivity losses-at diagnosis 5.4 0.0 16.2 16.2 Productivity losses-at visit 2 0.8 0.0 6.6 6.6 Productivity losses-at visit 3 1.4 0.0 7.3 7.3 Productivity losses-at visit 4 2.7 0.0 9.1 9.1 Overall Productivity losses 13.0 1.2 40.5 39.4 Productivity losses were valued using the human‑capital approach (hours lost × hourly wage). Productivity losses across socio-economic characteristics In Table 6 , Caregivers from poorer households had significantly lower rank sums (rank sum US $ 4.63) (p = 0.001) compared to the slightly rich (rank sum US $ 6.77), suggesting higher productivity losses among wealthier caregivers. The highest productivity losses were seen among caregivers with patients that were pulmonary bacteriologically confirmed (P-BC) TB cases (p = 0.001). Caregivers whose children had previous hospitalizations incurred significantly higher productivity losses (rank sum US $ 1.17) (p = 0.005). Caregivers involved in community-based DOT (rank sum US $ 6.30) and self-administered approaches (rank sum US $ 6.51) reported higher productivity losses than those using facility-based DOT (p = 0.001). Currently hospitalized: caregivers who had patients that were currently hospitalized (US $ 0.06) experienced lower productivity losses(p = 0.039) while those of younger children (0–4 years) incurred higher productivity losses (rank sum US $ 3.22) (p = 0.001). Table 6 Comparison of productivity losses by socio-economic characteristics Category N Rank Sum (US $ ) p-value Wealth Index Poorer 130 4.63 0.001 Moderate 66 2.83 Slightly rich 128 6.77 Type of TB Diagnosis EPTB 1 0.04 0.001 P-BC 265 10.58 P-CD 58 3.62 Type of TB Disease DS-TB 303 13.11 0.069 MDR/XDR-TB 21 1.12 Type of TB Case New Case 323 14.20 0.480 Retreatment Case 1 0.03 Treatment Phase Completed Treatment 233 9.88 0.075 Continuous Phase 58 2.94 Intensive Phase 33 1.41 Currently Hospitalized No 88 1.07 0.039 Yes 3 0.06 Previously Hospitalized No 204 6.20 0.005 Yes 29 1.17 DOT Status CB DOT 164 6.30 0.001 FB DOT 33 1.41 Self-administered 127 6.51 Pick Up Drugs No 15 0.19 0.052 Yes 112 2.01 Household Size < 5 Members 79 3.41 0.579 5–9 Members 199 8.64 10 + Members 46 2.18 Child Age Group 0–4 Years 59 3.22 0.001 5–9 Years 126 5.78 10–14 Years 90 3.30 15–19 Years 49 1.93 Caregiver Sex Female 240 10.84 0.125 Male 84 3.39 Marital Status Married 199 9.25 0.07 Separated/Widowed 96 3.81 Single 29 1.17 Child Sex Female 156 6.61 0.277 Male 168 7.62 Child Attending School No 97 3.97 0.163 Yes 227 10.26 HIV Status Negative 305 13.26 0.405 Positive 13 0.68 Unknown 6 0.30 Productivity losses were valued using the human‑capital approach (hours lost × hourly wage; see Methods). Because distributions were skewed, medians (IQR) are presented and groups compared using Wilcoxon rank‑sum (two levels) or Kruskal–Wallis (≥ 3 levels) tests; pairwise post‑hoc comparisons used Dunn tests with Holm adjustment. Two‑sided α = 0.05. Missing wage/time values were handled by complete‑case analysis for the respective comparison. Catastrophic health expenditures among pediatric TB patients (0 to 19 years) The findings in Table 7 showed that at the 10% threshold, 43.5% (n = 141) of households faced CHE, while 22.5% (n = 73) and 18.2% (n = 59) experienced CHE at the 25% and 40% thresholds, respectively. The burden of CHE was highest among children with P-BC, accounting for 80.1% of CHE cases at 10%, 78.1% at 25%, and 76.3% at 40%. Children in the continuous (23.4%) and intensive phases (8.5%) of treatment also faced CHE at the 10% threshold. Self-administered DOT was associated with high CHE rates: 45.4% at 10%, 47.9% at 25%, and 47.5% at 40%. Across wealth categories, CHE was reported in 42.3% of poorer, 45.5% of moderate, and 43.7% of slightly rich households at the 10% threshold. Additionally, Bugembe (10.6%) and ST. Benedict (23.4%) health facilities recorded higher CHE rates at the 10% level. Table 7 Catastrophic health expenditure at 10%, 25% and 40% threshold CHE-10% CHE-25% CHE-40% CHE No CHE CHE No CHE CHE No CHE N 141 (43.5%) 183 (56.5%) 73 (22.5%) 251 (77.5%) 59 (18.2%) 265 (81.8%) The type of TB diagnosis EPTB 1 (0.7%) 0 (0.0%) 1 (1.4%) 0 (0.0%) 1 (1.7%) 0 (0.0%) P-BC 113 (80.1%) 152 (83.1%) 57 (78.1%) 208 (82.9%) 45 (76.3%) 220 (83.0%) P-CD 27 (19.1%) 31 (16.9%) 15 (20.5%) 43 (17.1%) 13 (22.0%) 45 (17.0%) The type of TB disease DS-TB 129 (91.5%) 174 (95.1%) 68 (93.2%) 235 (93.6%) 56 (94.9%) 247 (93.2%) MDR/ XDR-TB 12 (8.5%) 9 (4.9%) 5 (6.8%) 16 (6.4%) 3 (5.1%) 18 (6.8%) The type of TB case New case 140 (99.3%) 183 (100.0%) 73 (100.0%) 250 (99.6%) 59 (100.0%) 264 (99.6%) Re-treatment case 1 (0.7%) 0 (0.0%) 0 (0.0%) 1 (0.4%) 0 (0.0%) 1 (0.4%) The phase of TB treatment Completed 96 (68.1%) 137 (74.9%) 46 (63.0%) 187 (74.5%) 38 (64.4%) 195 (73.6%) Continuous phase 33 (23.4%) 25 (13.7%) 18 (24.7%) 40 (15.9%) 14 (23.7%) 44 (16.6%) Intensive Phase 12 (8.5%) 21 (11.5%) 9 (12.3%) 24 (9.6%) 7 (11.9%) 26 (9.8%) Patient currently hospitalized No 43 (95.6%) 45 (97.8%) 27 (100.0%) 61 (95.3%) 21 (100.0%) 67 (95.7%) Yes 2 (4.4%) 1 (2.2%) 0 (0.0%) 3 (4.7%) 0 (0.0%) 3 (4.3%) Patient been previously Hospitalized No 81 (84.4%) 123 (89.8%) 35 (76.1%) 169 (90.4%) 29 (76.3%) 175 (89.7%) Yes 15 (15.6%) 14 (10.2%) 11 (23.9%) 18 (9.6%) 9 (23.7%) 20 (10.3%) DOT status CB DOT 69 (48.9%) 95 (51.9%) 36 (49.3%) 128 (51.0%) 29 (49.2%) 135 (50.9%) FB DOT 8 (5.7%) 25 (13.7%) 2 (2.7%) 31 (12.4%) 2 (3.4%) 31 (11.7%) Self-administered 64 (45.4%) 63 (34.4%) 35 (47.9%) 92 (36.7%) 28 (47.5%) 99 (37.4%) Pick-up TB drugs No 8 (12.5%) 7 (11.1%) 2 (5.7%) 13 (14.1%) 2 (7.1%) 13 (13.1%) Yes 56 (87.5%) 56 (88.9%) 33 (94.3%) 79 (85.9%) 26 (92.9%) 86 (86.9%) Number of household members less than 5 members 36 (25.5%) 43 (23.5%) 23 (31.5%) 56 (22.3%) 18 (30.5%) 61 (23.0%) 5-9members 91 (64.5%) 108 (59.0%) 45 (61.6%) 154 (61.4%) 39 (66.1%) 160 (60.4%) 10 + members 14 (9.9%) 32 (17.5%) 5 (6.8%) 41 (16.3%) 2 (3.4%) 44 (16.6%) Age ped-TB patient 0–4 yrs 23 (16.3%) 36 (19.7%) 14 (19.2%) 45 (17.9%) 12 (20.3%) 47 (17.7%) 5-9yrs 56 (39.7%) 70 (38.3%) 31 (42.5%) 95 (37.8%) 24 (40.7%) 102 (38.5%) 10-14yrs 41 (29.1%) 49 (26.8%) 18 (24.7%) 72 (28.7%) 13 (22.0%) 77 (29.1%) 15-19yrs 21 (14.9%) 28 (15.3%) 10 (13.7%) 39 (15.5%) 10 (16.9%) 39 (14.7%) Health facility AIC Jinja 14 (9.9%) 49 (26.8%) 5 (6.8%) 58 (23.1%) 3 (5.1%) 60 (22.6%) Bugembe 15 (10.6%) 10 (5.5%) 14 (19.2%) 11 (4.4%) 13 (22.0%) 12 (4.5%) Family Hope Jinja 22 (15.6%) 26 (14.2%) 7 (9.6%) 41 (16.3%) 6 (10.2%) 42 (15.8%) Jinja RRH 54 (38.3%) 53 (29.0%) 28 (38.4%) 79 (31.5%) 22 (37.3%) 85 (32.1%) Mpumudde 2 (1.4%) 3 (1.6%) 1 (1.4%) 4 (1.6%) 1 (1.7%) 4 (1.5%) ST.Benedict 33 (23.4%) 27 (14.8%) 18 (24.7%) 42 (16.7%) 14 (23.7%) 46 (17.4%) Walukuba 1 (0.7%) 15 (8.2%) 0 (0.0%) 16 (6.4%) 0 (0.0%) 16 (6.0%) Wealth Index Poorer 55 (42.3%) 75 (57.7%) 31 (23.8%) 99 (76.2%) 20 (20.0%) 104 (80.0%) Moderate 30 (45.5%) 36 (54.5%) 15 (22.7%) 51 (77.3%) 11 (16.7%) 55 (83.3%) Slightly rich 56 (43.7%) 72 (56.3%) 27 (21.1%) 101 (78.9%) 22 (17.2%) 106 (82.8%) Primary outcome: CHE defined as total TB‑related costs ≥ 20% of annual household income (WHO End TB indicator); 10%, 25%, and 40% thresholds shown as sensitivity analyses. A capacity‑to‑pay analysis using 40% of non‑food expenditure is also reported (see Methods). Cost components include direct medical, direct non‑medical (transport, food), and monetized productivity losses unless otherwise specified. Discussion The study assessed the economic burden of pediatric and adolescent TB in Jinja District, Uganda. While TB drugs were provided for free, caregivers incurred average costs of US $ 1.42 for diagnosis such as chest X-ray costs, GeneXpert diagnosis especially for PNFPs, US $ 0.57 for hospitalization, US $ 2.49 for travel, and US $ 1.36 for food during treatment. The overall mean cost of TB care per caregiver was US $ 4.10 excluding food, and US $ 5.33 with food. In addition to direct costs, caregivers also experienced productivity losses, with a median total of US $ 12.97 per treatment episode, highest at diagnosis US $ 5.41. Productivity losses were greater among caregivers of younger children (0–4 years), those whose children had been hospitalized, and users of community-based or self-administered DOT. At the 10% income threshold, 43.5% of households experienced CHE, decreasing to 22.5% and 18.2% at the 25% and 40% thresholds, respectively. CHE was more common among children in continuous or intensive treatment phases, households using self-administered DOT, and those receiving care from specific facilities like ST. Benedict and Bugembe. The average medical cost per caregiver, excluding food per month, was high and even rose when food expenses were included thus increasing the overall average monthly medical cost experienced by caregivers of pediatric TB patients. Most caregivers or TB patients who receive TB care from public facilities are not supposed to incur any medical costs in the treatment of pediatric TB. This is because in all the public health facility diagnosis and treatment of TB is offered at no cost. In some cases, the TB patients are not supposed to incur transport costs because community linkage facilitators (CLFs) take the drugs to the patients at their home. However, this study shows that the caregivers and patients mainly incurred travel costs and diagnostic expenses such as chest x-ray during the treatment of pediatric TB. The findings in this study showed lower average direct medical costs for the pediatric and adolescent TB patients compared to studies that were conducted among adult TB patients in Kenya ( $ 254.61) and in Cameroon ( $ 120.04) [ 25 ]. This is because in Jinja some of the patients were under the community-based DOT where they were diagnosed from home, given treatment at home and follow-up visits were also done at the home of the patient by the health workers. Also being a study among pediatric and adolescents, some may have been taken to facilities by caregivers whose unit cost (amount lost) could be lower when compared to adult patients. Therefore, some of the patients didn’t have to go to the health facility which reduced the direct medical costs they would have incurred. However, in Kenya and Cameroon the costs were mainly incurred in travel and food. The study showed that most of the costs incurred were indirect costs of food and transport, similar to a study conducted in Ethiopia that showed that families spent up to 25% of their monthly income on transportation alone during TB treatment [ 26 ]. This highlights the paradox of “free TB care” where indirect costs still pose barriers to access and adherence. The results showed that caregivers experienced a decrease in daily work hours after a child’s TB diagnosis, indicating economic impact. Time spent on review appointments also may have contributed to lost income and productivity. Where the study further showed that caregivers lost relatively some amount of money that would have helped in the social economic development of the household due to time spent during TB care and management. The findings in this study showed that a lot of time was spent taking care of pediatric and adolescent TB patients compared to findings of another study conducted in Cameroon where on a monthly average 18.2 hours were spent [ 25 ]. Whist another study in Uganda showed 32.1 hours approximately was lost taking care of TB patient by the caregiver [ 13 ]. The study showed that most time was spent during the initial diagnosis of TB this is because it included TB and HIV diagnosis which may take about 2 hours, chest x-ray, health education, and then TB drug administration. For MDR-TB, the time lost is higher since the patient spends more time on treatment where she/he has many tests such as culture tests for each monthly review for a period of 9 to 12 months of treatment compared to DS-TB of 6 months. In this study, the productivity loss was high where on a monthly average a caregiver, would lose approximately ( $ 100) due to not engaging in productive work but instead, taking care of a pediatric TB patient. The study found out that caregivers who practiced self-administered and community-based DOT had more productivity loss compared to those who had facility based because they had to take off time to pick the drugs and also witness the child taking the drugs on a daily basis. For some they had to wait for the CLF to come and administer the drugs to the patient which kept the caregiver from work. These findings show a relatively lower productivity loss compared to a study conducted in DR Congo that showed that 428 hours were lost due to TB thus showing a higher productivity loss by caregivers [ 27 ].This is because most the TB patients had to move long distances to the health facility for treatment thus spending more time on the road. The study showed that most of the participants experienced catastrophic health costs at a threshold of 10% where slightly less than half of the caregivers used 10% of their household income on the treatment and management of pediatric TB. Most of this money went into indirect costs such as travel and food, however, they also incurred diagnostic costs such as chest x-ray andGeneXpert (for PNFP). Results showed that very few MDR-TB patients incurred CHEs because they were provided with adherence enablers that entailed travel refund, food items which reduced CHE and increased the household income for some caregivers. These findings show that CHE at a threshold of 20% are lower than a study conducted in Uganda in 2017 that showed that 53.1% of the patients experienced CHE compared to 22.5% of caregivers of pediatric TB [ 13 ]. This because in 2017, MDR-TB patients had not started receiving adherence enablers such as food and transport refund additionally the treatment period was longer. Therefore, this implies that provision of TB adherence enablers and reduction of TB treatment period due to improved TB and MDR-TB regimens reduces CHE significantly. Strength and limitations of the study This study is among the first economic study in Uganda specifically examining the time and financial burden of caring for children with TB. By focusing on caregivers' time loss before, during, and after treatment, the study provides valuable insights into the costs often overlooked in pediatric and adolescent TB care. On the other hand, the study relied on self-reported data, which may be subjected to recall bias, especially when caregivers were asked to estimate time spent on activities over several months. Conclusion This study has showed that despite TB treatment being free at health facilities in Uganda caregivers of pediatric TB patients still faced significant economic burden. They incurred expenditure on TB treatment and lost working time due to taking care of the sick children. Most of these costs were incurred at diagnosis, travel to the facility, and feeding, particularly when accessing care from private-not-for-profit facilities. In addition to direct costs, caregivers also experienced productivity losses, particularly during the initial stages of TB diagnosis and follow-up reviews. The study showed that a number of households experienced catastrophic health expenditures due to pediatric TB patients. Interventions to eliminate TB should incorporate initiatives to reduce catastrophic expenditures such as offering food incentives to the households. Abbreviations AIC – AIDS Information Centre (context: AIC Jinja) CB DOT – Community-Based Directly Observed Therapy CHE – Catastrophic Health Expenditure CLFs – Community Linkage Facilitators DOT – Directly Observed Therapy DS-TB – Drug-Susceptible Tuberculosis EPTB – Extra-Pulmonary Tuberculosis FB DOT – Facility-Based Directly Observed Therapy GA – Gastric Aspiration GF – Global Fund IS – Induced Sputum MDR-TB – Multi-Drug Resistant Tuberculosis P-BC – Pulmonary Bacteriologically Confirmed TB PCA – Principal Component Analysis P-CD – Pulmonary Clinically Diagnosed TB PNFPs – Private Not-for-Profit facilities RRH – Regional Referral Hospital TB – Tuberculosis VHTs – Village Health Teams XDR-TB – Extensively Drug-Resistant Tuberculosis Declarations Ethical approval and consent to participate This study was conducted in accordance with the principles of the Declaration of Helsinki. The study was approved by Makerere University school of Public Health - Research and Ethics Committee (SPH-2024-587). Permission was sought at districts level (from the office of the district health office of Jinja), and the health facility in-charges. Written informed consent was obtained from all the study participants. For participants below the 18 years of age (minors), written informed consent was obtained from a parent or legally authorized guardian before participation in the study. In addition, assent was also sought from the minors themselves before they participated in the study. They appended their signatures or thumb prints after they had read through the consent form that was provided to them and all their questions answered by the research team. Data collection forms i.e. study tools did not include names but rather codes to protect the identity of the individual. Data was kept under lock and key and it was accessed by the study staff and the researchers. Consent for publication Not Applicable Clinical trial number Not Applicable. Availability of data and materials The data analyzed during this study is available on reasonable request from the corresponding author. Competing interests The authors declare that they have no competing interests. Funding This work was supported by the Royal Society of Tropical Medicine and Hygiene (RSTMH) under the RSTMH Early Career Researchers Award – 2024 (id. 36507365). The views expressed herein are those of the authors and not necessarily those of RSTMH. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No author received salary from the funders. Funding was received from The Royal Society of Tropical Medicine and Hygiene (RSTMH) under the early career grants for conducting this study Author’s contributions PMA and CT developed and designed the study with guidance from RN. PMA supervised the data collection and the data analysis and drafted the manuscript. PMA, CT and RN carried out the data analysis and writing of manuscript. MM, PK, JT, and MSP played major roles in the conceptualization and design of the study, interpretation of the data and writing of the manuscript. RN critically reviewed and edited the draft manuscript. All the authors read and approved the final version of the manuscript. Acknowledgements The authors would like to thank research assistants: Nalunkuuma Aminah, Lwasa Paul, Nakaima Joan, Mudondo Cogra, Bulolo Edward Bossa, and Nabulime Viola. We would like to appreciate Were Edward, the Jinja District Principal Health Inspector, for his support with administrative permission and community entry. References Muniyandi, M., et al., Catastrophic costs due to tuberculosis in South India: comparison between active and passive case finding. Transactions of the Royal Society of Tropical Medicine and Hygiene, 2020. 114 (3): p. 185-192. WHO, GLOBAL TUBERCULOSIS REPORT 2023. 2023. Wobudeya, E., et al., Epidemiology of tuberculosis in children in Kampala district, Uganda, 2009–2010; a retrospective cross-sectional study. BMC public health, 2015. 15 : p. 1-8. Organization, W.H., State of inequality: HIV, tuberculosis and malaria. 2021. Adeleke, O.A., R.K. Hayeshi, and H. Davids, Development and evaluation of a reconstitutable dry suspension containing isoniazid for flexible pediatric dosing. Pharmaceutics, 2020. 12 (3): p. 286. Maphalle, L.N., et al., Pediatric Tuberculosis Management: A Global Challenge or Breakthrough? Children, 2022. 9 (8): p. 1120. WHO, Adolescent Pregnancy Key Facts. 2022. WHO, WHO Tuberculosis Key Facts 2022. 2022. Uplekar, M., et al., WHO's new end TB strategy. The Lancet, 2015. 385 (9979): p. 1799-1801. Tanimura, T., et al., Financial burden for tuberculosis patients in low-and middle-income countries: a systematic review. European Respiratory Journal, 2014. 43 (6): p. 1763-1775. Barter, D.M., et al., Tuberculosis and poverty: the contribution of patient costs in sub-Saharan Africa–a systematic review. BMC public health, 2012. 12 : p. 1-21. Prasanna, T., et al., Catastrophic costs of tuberculosis care: a mixed methods study from Puducherry, India. Global health action, 2018. 11 (1): p. 1477493. Muttamba, W., et al., Households experiencing catastrophic costs due to tuberculosis in Uganda: magnitude and cost drivers. BMC Public Health, 2020. 20 : p. 1-10. Perez-Velez, C.M., C.L. Roya-Pabon, and B.J. Marais, A systematic approach to diagnosing intra-thoracic tuberculosis in children. Journal of Infection, 2017. 74 : p. S74-S83. Shah, K., et al., The socioeconomic burden of pediatric tuberculosis and role of child-sensitive social protection. BMC Public Health, 2023. 23 (1): p. 2339. Walcott, R.L., et al., There’s no such thing as a free TB diagnosis: Catastrophic TB costs in Urban Uganda. Global public health, 2020. 15 (6): p. 877-888. Atkins, S., et al., The socioeconomic impact of tuberculosis on children and adolescents: a scoping review and conceptual framework. BMC Public Health, 2022. 22 (1): p. 2153. Ekuka, G., et al., Pre-diagnostic drop out of presumptive TB patients and its associated factors at Bugembe Health Centre IV in Jinja, Uganda. African Health Sciences, 2020. 20 (2): p. 633-640. WHO, World Health Organization Tuberculosis Country Profile: Uganda 2017. 2018. Government, J.L. Jinja District Local Government - Economic Activity . 2025 [cited 2025 25-12-2025]; Available from: https://jinja.go.ug/lg/overview. Organization, W.H., Tuberculosis patient cost surveys: a handbook. 2017. De Broucker, G., et al., The economic burden of measles in children under five in Uganda. Vaccine: X, 2020. 6 : p. 100077. Getachew, N., et al., Catastrophic health expenditure and associated factors among households of non community based health insurance districts, Ilubabor zone, Oromia regional state, southwest Ethiopia. International Journal for Equity in Health, 2023. 22 (1): p. 40. BoU. Bank Of Uganda Exchange rates for the United States Dollar (USD) . 2024 [cited 2024 12-10-2024]; Available from: https://www.bou.or.ug/bouwebsite/ExchangeRates/. Mafirakureva, N., et al., Household costs incurred when seeking and receiving paediatric tuberculosis services: a survey in Cameroon and Kenya. Journal of Global Health Reports, 2023. 7 : p. e2023071. Datiko, D.G., D. Jerene, and P. Suarez, Patient and health system delay among TB patients in Ethiopia: Nationwide mixed method cross-sectional study. BMC Public Health, 2020. 20 (1): p. 1126. Kaswa, M., et al., The economic burden of TB-affected households in DR Congo. The International Journal of Tuberculosis and Lung Disease, 2021. 25 (11): p. 923-932. Additional Declarations No competing interests reported. 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P.","lastName":"Sekadde","suffix":""},{"id":618155969,"identity":"68724eeb-19dd-4ad4-af0f-eb7d35f4df68","order_by":4,"name":"Joan Tusabe","email":"","orcid":"","institution":"Uganda Case Western Reserve University Research Collaboration","correspondingAuthor":false,"prefix":"","firstName":"Joan","middleName":"","lastName":"Tusabe","suffix":""},{"id":618155970,"identity":"16cc1a17-330f-4cbe-9a7f-193970c6ad3d","order_by":5,"name":"Peter Kageni","email":"","orcid":"","institution":"Empacode Africa","correspondingAuthor":false,"prefix":"","firstName":"Peter","middleName":"","lastName":"Kageni","suffix":""},{"id":618155971,"identity":"213c5869-17e3-45dc-99e1-443fe647d86b","order_by":6,"name":"Rawlance Ndejjo","email":"","orcid":"","institution":"Makerere University, School of Public Health","correspondingAuthor":false,"prefix":"","firstName":"Rawlance","middleName":"","lastName":"Ndejjo","suffix":""}],"badges":[],"createdAt":"2026-03-05 14:08:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9040952/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9040952/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106724302,"identity":"83cc2881-6ded-493a-aa38-c028109ee25c","added_by":"auto","created_at":"2026-04-12 18:27:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2193271,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9040952/v1/1fbd4d45-0577-4883-94fd-9755c6a3ac4d.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Economic burden of caring for Pediatric Tuberculosis patients among households in Jinja District, Uganda: a cross-sectional study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eTuberculosis (TB) is a major public health concern that mainly affects the poorest individuals [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. In 2022, an estimated 1.3\u0026nbsp;million children were diagnosed with TB disease globally [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Uganda is among the high-burden TB countries (ref). Of the total TB cases detected in Uganda, 15% are among children aged 14 years and below[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTB is an important source of economic devastation, revolving poverty and illness, which has ensnared families, societies, and even countries globally, with the most vulnerable groups being women, children, and HIV patients [\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Despite TB services being free in most developing countries, patients and caregivers still face catastrophic costs that reduce their income and push them into poverty. Treatment and taking care of pediatric TB patients increases a family\u0026rsquo;s expenditure leading to catastrophic costs. The World Health Organization (WHO) reported that 48% of people with TB faced catastrophic costs in 2022 [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Previous studies focusing on adults diagnosed with TB found that 53.1% households in Uganda spent more than 20% of their household income on TB management [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe WHO defines catastrophic costs due to TB as costs that exceed 20% of the annual household income [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. These may be related to indirect costs such as income loss related to time lost from work or loss of employment in addition to direct costs [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. In sub-Saharan Africa, TB patients and their households often incur high costs when utilizing TB treatment and care [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. TB treatment and care-related costs were considered to be catastrophic because the patient costs incurred usually amounted to 10% or more of per capita incomes especially in the East African countries [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Catastrophic costs due to TB pose a great challenge in achieving \u0026ldquo;The End TB strategy\u0026rdquo; which aims at protecting households from catastrophic costs due to TB to 100% by 2025 [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The burden posed by the costs and the coping strategies adopted by the families determines the level of impoverishment [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe economic burden of TB is likely higher among pediatric and adolescent TB patients because it also affects the caregivers such as parents or guardians who have to take off time from work to nurse their children [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. There are also increased out-of-pocket medical expenses and lost income due to the illness [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. TB diagnosis among children utilizes methods such as chest X-rays, for clinical confirmation [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], aspiration of gastric fluid and suctioning following sputum induction (IS) which are costly [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Many families face catastrophic costs due to TB in addition to their earning low income [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. These factors can affect adherence to TB treatment leading to poor outcomes such as drug resistance or even death.\u003c/p\u003e \u003cp\u003eThe financial cost of pediatric tuberculosis (TB) is a noteworthy problem that has not received much attention with more attention on adult TB patients. The socioeconomic effects of tuberculosis (TB), both directly and indirectly, as household members or caregivers or as children and adolescents impacted by the disease [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e] is not well understood. This study therefore assessed the economic burden faced by households with pediatric and adolescent TB patients aged 0 to 19 years in Jinja district in Uganda.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design\u003c/h2\u003e \u003cp\u003eThis was a cross-sectional study, where data were collected at a single point in time. The expenditures and resource usage related to pediatric and adolescent TB treatment and care, as well as related activities, were collected retrospectively. The cost of treating and caring for a pediatric and adolescent TB patient and the productivity loss resulting from it were estimated from the viewpoints of the care-givers using an incidence-based costing technique combined with an ingredient-based approach.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy Setting\u003c/h3\u003e\n\u003cp\u003eThe study was conducted in Jinja, a district in the Southeastern Uganda. Jinja district had a TB incidence rate of 292/100,000 in 2017, higher than the Uganda national average of 201/100,000 [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The district is subdivided into three counties namely, Butembe, Kagoma and Jinja Municipality as well as six sub-Counties, 46 parishes and 381 villages. Economically, Jinja is majorly an industrial city hosting several agricultural, fish processing, construction and mining and quarrying industries [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. The district has several public and private-not-for-profit (PNFP) health facilities that provide TB services where data were collected. These included Jinja regional referral hospital, AIDS Information Center (AIC)- Jinja, Bugembe HCIII, Family Hope-Jinja, Mpumudde HCIII, ST. Benedict HC IV, and Walukuba HCIII. We included these facilities because they were diagnostic TB units that had a GeneXpert machine.\u003c/p\u003e\n\u003ch3\u003eStudy population\u003c/h3\u003e\n\u003cp\u003eThe study was conducted among pediatric and adolescent TB patients aged 0\u0026ndash;19 years who were receiving treatment at different levels of care (TB diagnostic and treatment units) in Jinja district during the period,1st July, 2023 to 30th June, 2024. Interviews were conducted among caregivers of eligible children and adolescents selected to participate in the study.\u003c/p\u003e\n\u003ch3\u003eSample size\u003c/h3\u003e\n\u003cp\u003eThis study was an incidence-based household survey that estimated the economic burden of pediatric and adolescent TB. Using the Kish\u0026ndash;Leslie formula for cross-sectional studies with the assumptions of p\u0026thinsp;=\u0026thinsp;15% (reference), z\u0026thinsp;=\u0026thinsp;1.96 and precision, σ, of 5%, we estimated a sample size of 324 respondents after adjusting for a 10% non-response.\u003c/p\u003e\n\u003ch3\u003eSampling procedure\u003c/h3\u003e\n\u003cp\u003eAt each selected facility, systematic sampling was used to select pediatric and adolescent TB patients whose caregivers participated in the survey. To achieve this, a list of eligible TB patients was made and organized according to date of registration of the patients for each facility for the period of 1st July, 2023 to 30th June, 2024. Then the n\u003csup\u003eth\u003c/sup\u003e patient was selected to participate in this study. The desired sample size for each facility was determined by (the number of Ped TB patients at each facility/ Total number of all the ped-TB patients in the seven health facilities) multiplied by the sample size (324 ped-TB Patients). This was determined by sampling interval (n\u003csup\u003eth\u003c/sup\u003e) = Total number of patients in the sampling frame (at each facility) / desired sample size for each facility using proportionate to size.\u003c/p\u003e \u003cp\u003eA list of selected patients aged 0\u0026ndash;19 years was generated, it included the patients\u0026rsquo; information, their next of kin (primary caregiver) with their telephone numbers and address. The interviews were conducted from the patients\u0026rsquo; homes as most were unreachable through the available telephone contacts. The research assistants with the support of the village health teams (VHTs) and Community Linkage Facilitators (CLFs) attached to the facility tracked patients to their homes as most of them received TB diagnosis and treatment from their homes.\u003c/p\u003e \u003cp\u003eWe didn\u0026rsquo;t include pediatric and adolescent TB patients whose outcome was transfer ins (these patients that were registered and start TB treatment from one TB unit and later are transferred to another facility). This was done to prevent double counting during selection of the participants.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData collection\u003c/h2\u003e \u003cp\u003eWe collected data using a survey tool from WHO called the Tuberculosis patient cost surveys: a handbook, 2017 that captured information on household costs and expenditures for pediatric TB patients [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. The study tools were pretested to ensure clarity, suitability and logical flow of questions and were revised before being used in the field. The tools were pre-tested at a non-participating community in Buikwe district. The questionnaire was administered to caregivers of the Ped-TB patients. The costing tool was designed to capture household income, expenditure and out-of-pocket payments incurred due to the disease.\u003c/p\u003e \u003cp\u003eCaregivers were interviewed to gather household and patient\u0026rsquo;s costs (in case they incurred the costs). Costs borne directly by the TB patient were solicited from the caregivers of pediatric TB patients. Information of those who died due to TB was acquired from the main caregiver. The survey tool also helped to collect and capture household income and expenditure and also out-of-pocket payments incurred due to the disease.\u003c/p\u003e \u003cp\u003eThe study questionnaire was translated into Lusoga, the commonly spoken language in Jinja, and interviews were conducted in the same language. Data collection were conducted by trained research assistants with experience in conducting costing studies and interviews who underwent a five-day training in preparation for the exercise.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eVariables:\u003c/h3\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eOutcome variables\u003c/h2\u003e \u003cp\u003eThis study had three outcome variables namely Costs incurred due to Ped-TB treatment, Productivity loss due to TB and Catastrophic health expenditures (CHE):\u003c/p\u003e \u003cp\u003eCosts incurred due to pediatric TB treatment \u0026ndash; This was determined using a questionnaire where the care givers were asked questions regarding how much they spent while taking care of the pediatric TB patients for a period of three to six months for drug-susceptible patients and 12 to 24 months for MDR-TB patients. These costs were categorized by TB status (susceptible TB and MDR-TB) and then the average costs presented for each.\u003c/p\u003e \u003cp\u003eProductivity loss due to TB \u0026ndash; This was determined using the questionnaire where the care givers were asked questions regarding how much time they took off from their work to look after the pediatric TB patient. The time was apportioned by TB status (susceptible TB and MDR-TB) and then the average productivity loss due to TB was presented for each.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eCatastrophic health expenditures (CHE)\u003c/h2\u003e \u003cp\u003eCHE was calculated using direct and indirect costs that is the annual income minus expenditures for the households. Data collected on expenditures comprised of food, clothing, supplies, leisure, tax paid, other healthcare expenses and other expenses including going to traditional herbalists and healers.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eIndependent variables\u003c/h2\u003e \u003cp\u003eThe independent variables included: sex, age, distance to the facility, wealth index, number of household members, TB characteristics such as type of TB, TB classification, and average income of the household .\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eData management and analysis\u003c/h2\u003e \u003cdiv id=\"Sec14\" class=\"Section3\"\u003e \u003ch2\u003eCosting approaches\u003c/h2\u003e \u003cp\u003eThe study determined societal costs using a combination of the costs borne by the caregivers of pediatric TB patients and those by the healthcare system. Differences within direct and indirect costs for TB treatment and care, and socio-economic status, service provider status, age, sex and residence were tested using relevant statistical tests such as rank sum test. In this study, principal component analysis (PCA) approach was used to score assets; which was ranked to determine wealth quintiles [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eCatastrophic health expenditures (CHE)\u003c/h2\u003e \u003cp\u003eA household experienced catastrophic health expenditures if it spent more than the following thresholds on pediatric TB management: 10% of its income, 20% of its monthly expenditures or 40% of its monthly expenditures without food [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eSocio-economic characteristics of participants\u003c/h2\u003e \u003cp\u003eOf the 324 participants, the majority were female (74.1%), with an average age of 38 years (SD 13.4), where 30\u0026ndash;39 years was the most predominant age group (34.0%). A half (50.0%) of the participants had only primary education and over 60% were married. Caregivers were mainly mothers (44.8%) and four in ten (40.1%) belonged to the poorer wealth index category (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocial-economic characteristics of caregivers of Ped-TB patients in Jinja\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge of participant\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15-19yrs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (2.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20-29yrs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e87 (26.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30-39yrs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e110 (34.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40-44yrs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54 (16.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50-59yrs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e33 (10.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e60\u0026thinsp;+\u0026thinsp;yrs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31 (9.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAverage age of participants (Standard deviation)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38 (\u0026plusmn;\u0026thinsp;13.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge of the child (TB patient)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;4 yrs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59 (18.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5-9yrs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e126 (38.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10-14yrs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e90 (27.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15-19yrs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49 (15.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAverage age of child (Standard deviation (SD))\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e9 years (\u0026plusmn;\u0026thinsp;4.7)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex of study participant\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e240 (74.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e84 (25.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex of TB patient\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e156 (48.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e168 (51.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReligion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnglican\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e96 (29.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBorn-Again/ Pentecostal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e57 (17.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCatholic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e92 (28.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMuslim\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e73 (22.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSDA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (1.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHighest level of education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone at all\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (8.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e162 (50.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e105 (32.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 (9.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eChild attending school\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e97 (29.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e227 (70.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e199 (61.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeparated/ Divorced or Widowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e96 (29.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle and never in a Union\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29 (9.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployment status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e87 (26.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFull time work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e58 (17.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePart time work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53 (16.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (3.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e114 (35.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRelationship with the Pediatric TB patient\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFather\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44 (13.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMother\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e145 (44.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSister/ Brother\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44 (13.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers (family relatives, friends)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e91 (28.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of adult household members\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;2 Household members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e201 (62.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u0026ndash;4 Household members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e92 (28.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5 and above HH members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31 (9.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of children in household\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;2 children\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e95 (29.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u0026ndash;4 children\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e114 (35.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026ndash;6 children\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e82 (25.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7 \u0026amp; more children\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e33 (10.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOverall number of household members\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eless than 5 members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e79 (24.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026ndash;9 members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e199 (61.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026thinsp;+\u0026thinsp;members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46 (14.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWealth index\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoorer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e130 (40.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66 (20.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSlightly Rich\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e128 (39.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003ePercentages use the full analysis sample (N\u0026thinsp;=\u0026thinsp;324); categories may not sum to N due to missing values. Mean age is presented as mean (SD). The household wealth index was derived via principal component analysis of assets and grouped for presentation. SD, standard deviation; IQR, interquartile range.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eAccess to care and TB status among pediatric TB patients\u003c/h2\u003e \u003cp\u003eFrom Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, most pediatric TB patients in Jinja were receiving care from Jinja Regional Referral Hospital (33.0%) and Health Centre III facilities (46.0%), with most facilities being public (53.4%). Pulmonary bacteriologically confirmed TB (P-BC) was the most common diagnostic approach (81.8%), and nearly all patients had drug-susceptible TB (93.5%). Patients with newly diagnosed TB cases were 99.7%. Most children were HIV-negative (94.1%) and had completed treatment (71.9%), while only a few were currently hospitalized (3.3%) or had been hospitalized previously (12.4%). Community-based directly observed treatment (DOT) (50.6%) was most common, followed by self-administered treatment (39.2%). The majority of caregivers picked up drugs regularly from the TB units (Jinja RRH, AIC- Jinja, Bugembe HCIII, Family Hope-Jinja, Mpumudde HCIII, ST. Benedict HC IV, and Walukuba HCIII) (88.2%) and only a very small fraction reported using traditional healers (2.2%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eShowing social- economic factors of caregivers of Ped-TB patients in Jinja\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHealth facility\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAIC Jinja\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e63 (19.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBugembe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25 (7.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily Hope Jinja\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e48 (14.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJinja RRH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e107 (33.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMpumudde\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (1.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eST. Benedict\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e60 (18.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWalukuba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16 (4.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of care of the facility\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHC III\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e149 (46.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHC IV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e44 (13.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGeneral Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26 (8.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRRH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e105 (32.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eType of facility\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrivate by not for Profit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e151 (46.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePublic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e173 (53.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe type of TB diagnosis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExtra-Pulmonary-TB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (0.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePulmonary-Bacteriologically Confirmed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e265 (81.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePulmonary-Clinically Diagnosed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e58 (17.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe type of TB disease\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDS-TB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e303 (93.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMDR-TB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21 (6.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe type of TB case\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNewly diagnosed TB case\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e323 (99.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRe-treatment case\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (0.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHIV status of the child\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e305 (94.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13 (4.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6 (1.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe phase of TB treatment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCompleted treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e233 (71.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eContinuous phase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e58 (17.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntensive Phase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33 (10.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePatient currently hospitalized\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e88 (96.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (3.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePatient was previously hospitalized\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e204 (87.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29 (12.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDOT used\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCB DOT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e164 (50.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFB DOT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33 (10.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-administered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e127 (39.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePick up of TB drugs\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15 (11.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e112 (88.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUsed traditional healers\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e317 (97.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (2.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"2\"\u003eFacility levels: HC III/HC IV, Health Centre Levels III/IV; RRH, Regional Referral Hospital; PNFP, Private Not‑for‑Profit. TB types: P‑BC, pulmonary bacteriologically confirmed; P‑CD, pulmonary clinically diagnosed; EPTB, extra‑pulmonary TB; DS‑TB, drug‑susceptible TB; MDR‑TB, multidrug‑resistant TB. DOT models: CB DOT, community‑based DOT; FB DOT, facility‑based DOT. HIV, human immunodeficiency virus; AIC, AIDS Information Center\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eEstimated costs incurred during treatment of pediatric TB patients among caregivers of households in Jinja.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eTB drugs were provided at no cost at the government facilities where most caregivers obtained them. However, caregivers incurred an average of US \u003cspan\u003e$\u003c/span\u003e1.4 mainly on diagnosis. On average, hospitalization costs were US \u003cspan\u003e$\u003c/span\u003e0.6 while out-of-pocket expense for travel to seek medical care, was US \u003cspan\u003e$\u003c/span\u003e2.5. The average cost of meals and food-related costs during treatment was US \u003cspan\u003e$\u003c/span\u003e1.4. Overall, the average total medical cost excluding food was US \u003cspan\u003e$\u003c/span\u003e4.1, and US \u003cspan\u003e$\u003c/span\u003e5.3 when food is included (Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAverage costs incurred during Pediatric TB management by the care giver\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCosts\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean (US \u003cspan\u003e$\u003c/span\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStd Deviation (\u0026plusmn;\u0026thinsp;US \u003cspan\u003e$\u003c/span\u003e)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTB-Drug related costs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiagnosis costs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospitalization costs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTravel cost to the facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMeals and foods costs during TB treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedical costs without food inclusive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedical costs with food\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAll costs were collected in Ugandan shillings (UGX) and converted to [2024] US dollars (US\u003cspan\u003e$\u003c/span\u003e) using an average exchange rate of [UGX. 3600] [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Costs refer to the treatment episode unless otherwise noted.; means (SD) are provided for comparability.\u003c/p\u003e \u003cp\u003e \u003cb\u003eEstimated productivity losses for caregivers of households with pediatric TB patients (0 to 19 years) in Jinja.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e shows that caregivers experienced a reduction in daily working hours after a pediatric TB diagnosis, with the median daily hours worked dropping from 10 to 7 hours. During the initial diagnosis and treatment phase, caregivers spent a median of 4 hours (IQR: 4), reflecting significant time investment. Follow-up reviews required less time but still varied, with the first and second reviews each taking a median of 1 hour and the final post-treatment review taking 2 hours.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMedian time spent by the caregiver in getting TB treatment for his child\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNumber of hours worked on a daily basis before pediatric TB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedian time (hours)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25th percentile\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75th percentile\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIQR\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of hours worked on a daily basis after pediatric TB diagnosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of hours spent during initial diagnosis and TB treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of hours spent during 1st review (month 2 of DS-TB treatment)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of hours spent during 2nd review (month 5 of DS-TB treatment)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of hours spent during 3rd review (post treatment review of DS-TB treatment)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTime includes travel, waiting, and consultation unless specified. Review visits correspond to DS‑TB months 2 and 5, and post‑treatment review\u003c/p\u003e \u003cp\u003eAt the time of diagnosis, the median productivity loss was US \u003cspan\u003e$\u003c/span\u003e 5.4, with an interquartile range (IQR) of US \u003cspan\u003e$\u003c/span\u003e16.2. Productivity losses decreased on subsequent visits, US \u003cspan\u003e$\u003c/span\u003e 0.8, US \u003cspan\u003e$\u003c/span\u003e 1.4, and 2.7 at visits 2, 3, and 4 respectively. The overall median productivity loss incurred during the course of TB management was US \u003cspan\u003e$\u003c/span\u003e13.0, with an IQR of US \u003cspan\u003e$\u003c/span\u003e39.4 (seen in Table \u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAverage productivity losses incurred during Pediatric TB management by the caregiver\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProductivity losses\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedian (US \u003cspan\u003e$\u003c/span\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25% - Percentiles (US \u003cspan\u003e$\u003c/span\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75% - Percentiles (US \u003cspan\u003e$\u003c/span\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIQR (US \u003cspan\u003e$\u003c/span\u003e)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProductivity losses-at diagnosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e16.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProductivity losses-at visit 2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProductivity losses-at visit 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProductivity losses-at visit 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverall Productivity losses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e40.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e39.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eProductivity losses were valued using the human‑capital approach (hours lost \u0026times; hourly wage).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eProductivity losses across socio-economic characteristics\u003c/h2\u003e \u003cp\u003eIn Table \u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e, Caregivers from poorer households had significantly lower rank sums (rank sum US \u003cspan\u003e$\u003c/span\u003e4.63) (p\u0026thinsp;=\u0026thinsp;0.001) compared to the slightly rich (rank sum US \u003cspan\u003e$\u003c/span\u003e6.77), suggesting higher productivity losses among wealthier caregivers. The highest productivity losses were seen among caregivers with patients that were pulmonary bacteriologically confirmed (P-BC) TB cases (p\u0026thinsp;=\u0026thinsp;0.001). Caregivers whose children had previous hospitalizations incurred significantly higher productivity losses (rank sum US \u003cspan\u003e$\u003c/span\u003e1.17) (p\u0026thinsp;=\u0026thinsp;0.005). Caregivers involved in community-based DOT (rank sum US \u003cspan\u003e$\u003c/span\u003e6.30) and self-administered approaches (rank sum US \u003cspan\u003e$\u003c/span\u003e6.51) reported higher productivity losses than those using facility-based DOT (p\u0026thinsp;=\u0026thinsp;0.001). Currently hospitalized: caregivers who had patients that were currently hospitalized (US \u003cspan\u003e$\u003c/span\u003e0.06) experienced lower productivity losses(p\u0026thinsp;=\u0026thinsp;0.039) while those of younger children (0\u0026ndash;4 years) incurred higher productivity losses (rank sum US \u003cspan\u003e$\u003c/span\u003e3.22) (p\u0026thinsp;=\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of productivity losses by socio-economic characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRank Sum (US \u003cspan\u003e$\u003c/span\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eWealth Index\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoorer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSlightly rich\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e128\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eType of TB Diagnosis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEPTB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP-BC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e265\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP-CD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eType of TB Disease\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDS-TB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e303\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.069\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMDR/XDR-TB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eType of TB Case\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNew Case\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e323\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.480\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRetreatment Case\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTreatment Phase\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCompleted Treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e233\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.075\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eContinuous Phase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntensive Phase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCurrently Hospitalized\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.039\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePreviously Hospitalized\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e204\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDOT Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCB DOT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e164\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFB DOT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-administered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePick Up Drugs\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.052\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHousehold Size\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5 Members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.579\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026ndash;9 Members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026thinsp;+\u0026thinsp;Members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eChild Age Group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;4 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026ndash;9 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;14 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15\u0026ndash;19 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaregiver Sex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e240\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.125\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.07\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeparated/Widowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eChild Sex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.277\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e168\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eChild Attending School\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.163\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e227\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHIV Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e305\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.405\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eProductivity losses were valued using the human‑capital approach (hours lost \u0026times; hourly wage; see Methods). Because distributions were skewed, medians (IQR) are presented and groups compared using Wilcoxon rank‑sum (two levels) or Kruskal\u0026ndash;Wallis (\u0026ge;\u0026thinsp;3 levels) tests; pairwise post‑hoc comparisons used Dunn tests with Holm adjustment. Two‑sided α\u0026thinsp;=\u0026thinsp;0.05. Missing wage/time values were handled by complete‑case analysis for the respective comparison.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eCatastrophic health expenditures among pediatric TB patients (0 to 19 years)\u003c/h2\u003e \u003cp\u003eThe findings in Table \u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e showed that at the 10% threshold, 43.5% (n\u0026thinsp;=\u0026thinsp;141) of households faced CHE, while 22.5% (n\u0026thinsp;=\u0026thinsp;73) and 18.2% (n\u0026thinsp;=\u0026thinsp;59) experienced CHE at the 25% and 40% thresholds, respectively. The burden of CHE was highest among children with P-BC, accounting for 80.1% of CHE cases at 10%, 78.1% at 25%, and 76.3% at 40%. Children in the continuous (23.4%) and intensive phases (8.5%) of treatment also faced CHE at the 10% threshold. Self-administered DOT was associated with high CHE rates: 45.4% at 10%, 47.9% at 25%, and 47.5% at 40%. Across wealth categories, CHE was reported in 42.3% of poorer, 45.5% of moderate, and 43.7% of slightly rich households at the 10% threshold. Additionally, Bugembe (10.6%) and ST. Benedict (23.4%) health facilities recorded higher CHE rates at the 10% level.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCatastrophic health expenditure at 10%, 25% and 40% threshold\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eCHE-10%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eCHE-25%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eCHE-40%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCHE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo CHE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCHE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNo CHE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCHE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNo CHE\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e141 (43.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e183 (56.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e73 (22.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e251 (77.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e59 (18.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e265 (81.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe type of TB diagnosis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEPTB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (0.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1 (1.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (1.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP-BC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e113 (80.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e152 (83.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e57 (78.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e208 (82.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e45 (76.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e220 (83.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP-CD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e27 (19.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31 (16.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15 (20.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e43 (17.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13 (22.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e45 (17.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe type of TB disease\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDS-TB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e129 (91.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e174 (95.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e68 (93.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e235 (93.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e56 (94.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e247 (93.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMDR/ XDR-TB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12 (8.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (4.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5 (6.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e16 (6.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (5.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18 (6.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe type of TB case\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNew case\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e140 (99.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e183 (100.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e73 (100.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e250 (99.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e59 (100.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e264 (99.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRe-treatment case\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (0.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1 (0.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 (0.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe phase of TB treatment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCompleted\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e96 (68.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e137 (74.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e46 (63.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e187 (74.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e38 (64.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e195 (73.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eContinuous phase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33 (23.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25 (13.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18 (24.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e40 (15.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e14 (23.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e44 (16.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntensive Phase\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12 (8.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (11.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9 (12.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e24 (9.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7 (11.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e26 (9.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePatient currently hospitalized\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e43 (95.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45 (97.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27 (100.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e61 (95.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21 (100.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e67 (95.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (4.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (2.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3 (4.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3 (4.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePatient been previously Hospitalized\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e81 (84.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e123 (89.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35 (76.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e169 (90.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e29 (76.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e175 (89.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15 (15.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14 (10.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (23.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e18 (9.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9 (23.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e20 (10.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDOT status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCB DOT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e69 (48.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e95 (51.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36 (49.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e128 (51.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e29 (49.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e135 (50.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFB DOT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (5.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25 (13.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2 (2.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e31 (12.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (3.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e31 (11.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-administered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e64 (45.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e63 (34.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35 (47.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e92 (36.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e28 (47.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e99 (37.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePick-up TB drugs\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (12.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (11.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2 (5.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13 (14.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (7.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e13 (13.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e56 (87.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e56 (88.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33 (94.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e79 (85.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e26 (92.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e86 (86.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of household members\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eless than 5 members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36 (25.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43 (23.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23 (31.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e56 (22.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18 (30.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e61 (23.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5-9members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e91 (64.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e108 (59.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45 (61.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e154 (61.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e39 (66.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e160 (60.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026thinsp;+\u0026thinsp;members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (9.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32 (17.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5 (6.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e41 (16.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (3.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e44 (16.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge ped-TB patient\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;4 yrs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23 (16.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36 (19.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14 (19.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e45 (17.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12 (20.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e47 (17.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5-9yrs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e56 (39.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e70 (38.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31 (42.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e95 (37.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e24 (40.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e102 (38.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10-14yrs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e41 (29.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49 (26.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18 (24.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e72 (28.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13 (22.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e77 (29.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15-19yrs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21 (14.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28 (15.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10 (13.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e39 (15.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10 (16.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e39 (14.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHealth facility\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAIC Jinja\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (9.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49 (26.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5 (6.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e58 (23.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (5.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e60 (22.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBugembe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15 (10.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (5.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14 (19.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11 (4.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13 (22.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e12 (4.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily Hope Jinja\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22 (15.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26 (14.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (9.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e41 (16.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6 (10.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e42 (15.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJinja RRH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e54 (38.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53 (29.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28 (38.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e79 (31.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22 (37.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e85 (32.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMpumudde\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (1.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (1.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1 (1.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4 (1.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (1.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4 (1.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eST.Benedict\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33 (23.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (14.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18 (24.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e42 (16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e14 (23.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e46 (17.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWalukuba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (0.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15 (8.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e16 (6.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16 (6.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWealth Index\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoorer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e55 (42.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75 (57.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31 (23.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e99 (76.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20 (20.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e104 (80.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30 (45.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36 (54.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15 (22.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e51 (77.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11 (16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e55 (83.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSlightly rich\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e56 (43.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e72 (56.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27 (21.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e101 (78.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22 (17.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e106 (82.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003ePrimary outcome: CHE defined as total TB‑related costs\u0026thinsp;\u0026ge;\u0026thinsp;20% of annual household income (WHO End TB indicator); 10%, 25%, and 40% thresholds shown as sensitivity analyses. A capacity‑to‑pay analysis using 40% of non‑food expenditure is also reported (see Methods). Cost components include direct medical, direct non‑medical (transport, food), and monetized productivity losses unless otherwise specified.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study assessed the economic burden of pediatric and adolescent TB in Jinja District, Uganda. While TB drugs were provided for free, caregivers incurred average costs of US \u003cspan\u003e$\u003c/span\u003e1.42 for diagnosis such as chest X-ray costs, GeneXpert diagnosis especially for PNFPs, US \u003cspan\u003e$\u003c/span\u003e0.57 for hospitalization, US \u003cspan\u003e$\u003c/span\u003e2.49 for travel, and US \u003cspan\u003e$\u003c/span\u003e1.36 for food during treatment. The overall mean cost of TB care per caregiver was US \u003cspan\u003e$\u003c/span\u003e4.10 excluding food, and US \u003cspan\u003e$\u003c/span\u003e5.33 with food. In addition to direct costs, caregivers also experienced productivity losses, with a median total of US \u003cspan\u003e$\u003c/span\u003e12.97 per treatment episode, highest at diagnosis US \u003cspan\u003e$\u003c/span\u003e5.41. Productivity losses were greater among caregivers of younger children (0\u0026ndash;4 years), those whose children had been hospitalized, and users of community-based or self-administered DOT. At the 10% income threshold, 43.5% of households experienced CHE, decreasing to 22.5% and 18.2% at the 25% and 40% thresholds, respectively. CHE was more common among children in continuous or intensive treatment phases, households using self-administered DOT, and those receiving care from specific facilities like ST. Benedict and Bugembe.\u003c/p\u003e \u003cp\u003eThe average medical cost per caregiver, excluding food per month, was high and even rose when food expenses were included thus increasing the overall average monthly medical cost experienced by caregivers of pediatric TB patients. Most caregivers or TB patients who receive TB care from public facilities are not supposed to incur any medical costs in the treatment of pediatric TB. This is because in all the public health facility diagnosis and treatment of TB is offered at no cost. In some cases, the TB patients are not supposed to incur transport costs because community linkage facilitators (CLFs) take the drugs to the patients at their home. However, this study shows that the caregivers and patients mainly incurred travel costs and diagnostic expenses such as chest x-ray during the treatment of pediatric TB. The findings in this study showed lower average direct medical costs for the pediatric and adolescent TB patients compared to studies that were conducted among adult TB patients in Kenya (\u003cspan\u003e$\u003c/span\u003e254.61) and in Cameroon (\u003cspan\u003e$\u003c/span\u003e120.04) [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. This is because in Jinja some of the patients were under the community-based DOT where they were diagnosed from home, given treatment at home and follow-up visits were also done at the home of the patient by the health workers. Also being a study among pediatric and adolescents, some may have been taken to facilities by caregivers whose unit cost (amount lost) could be lower when compared to adult patients. Therefore, some of the patients didn\u0026rsquo;t have to go to the health facility which reduced the direct medical costs they would have incurred. However, in Kenya and Cameroon the costs were mainly incurred in travel and food. The study showed that most of the costs incurred were indirect costs of food and transport, similar to a study conducted in Ethiopia that showed that families spent up to 25% of their monthly income on transportation alone during TB treatment [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. This highlights the paradox of \u0026ldquo;free TB care\u0026rdquo; where indirect costs still pose barriers to access and adherence.\u003c/p\u003e \u003cp\u003eThe results showed that caregivers experienced a decrease in daily work hours after a child\u0026rsquo;s TB diagnosis, indicating economic impact. Time spent on review appointments also may have contributed to lost income and productivity. Where the study further showed that caregivers lost relatively some amount of money that would have helped in the social economic development of the household due to time spent during TB care and management. The findings in this study showed that a lot of time was spent taking care of pediatric and adolescent TB patients compared to findings of another study conducted in Cameroon where on a monthly average 18.2 hours were spent [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Whist another study in Uganda showed 32.1 hours approximately was lost taking care of TB patient by the caregiver [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. The study showed that most time was spent during the initial diagnosis of TB this is because it included TB and HIV diagnosis which may take about 2 hours, chest x-ray, health education, and then TB drug administration. For MDR-TB, the time lost is higher since the patient spends more time on treatment where she/he has many tests such as culture tests for each monthly review for a period of 9 to 12 months of treatment compared to DS-TB of 6 months.\u003c/p\u003e \u003cp\u003eIn this study, the productivity loss was high where on a monthly average a caregiver, would lose approximately (\u003cspan\u003e$\u003c/span\u003e100) due to not engaging in productive work but instead, taking care of a pediatric TB patient. The study found out that caregivers who practiced self-administered and community-based DOT had more productivity loss compared to those who had facility based because they had to take off time to pick the drugs and also witness the child taking the drugs on a daily basis. For some they had to wait for the CLF to come and administer the drugs to the patient which kept the caregiver from work. These findings show a relatively lower productivity loss compared to a study conducted in DR Congo that showed that 428 hours were lost due to TB thus showing a higher productivity loss by caregivers [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].This is because most the TB patients had to move long distances to the health facility for treatment thus spending more time on the road.\u003c/p\u003e \u003cp\u003eThe study showed that most of the participants experienced catastrophic health costs at a threshold of 10% where slightly less than half of the caregivers used 10% of their household income on the treatment and management of pediatric TB. Most of this money went into indirect costs such as travel and food, however, they also incurred diagnostic costs such as chest x-ray andGeneXpert (for PNFP). Results showed that very few MDR-TB patients incurred CHEs because they were provided with adherence enablers that entailed travel refund, food items which reduced CHE and increased the household income for some caregivers. These findings show that CHE at a threshold of 20% are lower than a study conducted in Uganda in 2017 that showed that 53.1% of the patients experienced CHE compared to 22.5% of caregivers of pediatric TB [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. This because in 2017, MDR-TB patients had not started receiving adherence enablers such as food and transport refund additionally the treatment period was longer. Therefore, this implies that provision of TB adherence enablers and reduction of TB treatment period due to improved TB and MDR-TB regimens reduces CHE significantly.\u003c/p\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eStrength and limitations of the study\u003c/h2\u003e \u003cp\u003eThis study is among the first economic study in Uganda specifically examining the time and financial burden of caring for children with TB. By focusing on caregivers' time loss before, during, and after treatment, the study provides valuable insights into the costs often overlooked in pediatric and adolescent TB care. On the other hand, the study relied on self-reported data, which may be subjected to recall bias, especially when caregivers were asked to estimate time spent on activities over several months.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study has showed that despite TB treatment being free at health facilities in Uganda caregivers of pediatric TB patients still faced significant economic burden. They incurred expenditure on TB treatment and lost working time due to taking care of the sick children. Most of these costs were incurred at diagnosis, travel to the facility, and feeding, particularly when accessing care from private-not-for-profit facilities. In addition to direct costs, caregivers also experienced productivity losses, particularly during the initial stages of TB diagnosis and follow-up reviews. The study showed that a number of households experienced catastrophic health expenditures due to pediatric TB patients. Interventions to eliminate TB should incorporate initiatives to reduce catastrophic expenditures such as offering food incentives to the households.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAIC \u0026ndash; AIDS Information Centre (context: AIC Jinja)\u003c/p\u003e\n\u003cp\u003eCB DOT \u0026ndash; Community-Based Directly Observed Therapy\u003c/p\u003e\n\u003cp\u003eCHE \u0026ndash; Catastrophic Health Expenditure\u003c/p\u003e\n\u003cp\u003eCLFs \u0026ndash; Community Linkage Facilitators\u003c/p\u003e\n\u003cp\u003eDOT \u0026ndash; Directly Observed Therapy\u003c/p\u003e\n\u003cp\u003eDS-TB \u0026ndash; Drug-Susceptible Tuberculosis\u003c/p\u003e\n\u003cp\u003eEPTB \u0026ndash; Extra-Pulmonary Tuberculosis\u003c/p\u003e\n\u003cp\u003eFB DOT \u0026ndash; Facility-Based Directly Observed Therapy\u003c/p\u003e\n\u003cp\u003eGA \u0026ndash; Gastric Aspiration\u003c/p\u003e\n\u003cp\u003eGF \u0026ndash; Global Fund\u003c/p\u003e\n\u003cp\u003eIS \u0026ndash; Induced Sputum\u003c/p\u003e\n\u003cp\u003eMDR-TB \u0026ndash; Multi-Drug Resistant Tuberculosis\u003c/p\u003e\n\u003cp\u003eP-BC \u0026ndash; Pulmonary Bacteriologically Confirmed TB\u003c/p\u003e\n\u003cp\u003ePCA \u0026ndash; Principal Component Analysis\u003c/p\u003e\n\u003cp\u003eP-CD \u0026ndash; Pulmonary Clinically Diagnosed TB\u003c/p\u003e\n\u003cp\u003ePNFPs \u0026ndash; Private Not-for-Profit facilities\u003c/p\u003e\n\u003cp\u003eRRH \u0026ndash; Regional Referral Hospital\u003c/p\u003e\n\u003cp\u003eTB \u0026ndash; Tuberculosis\u003c/p\u003e\n\u003cp\u003eVHTs \u0026ndash; Village Health Teams\u003c/p\u003e\n\u003cp\u003eXDR-TB \u0026ndash; Extensively Drug-Resistant Tuberculosis\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the principles of the Declaration of Helsinki. The study was approved by Makerere University school of Public Health - Research and Ethics Committee (SPH-2024-587). Permission was sought at districts level (from the office of the district health office of Jinja), and the health facility in-charges. Written informed consent was obtained from all the study participants. For participants below the 18 years of age (minors), written informed consent was obtained from a parent or legally authorized guardian before participation in the study. In addition, assent was also sought from the minors themselves before they participated in the study. They appended their signatures or thumb prints after they had read through the consent form that was provided to them and all their questions answered by the research team. Data collection forms i.e. study tools did not include names but rather codes to protect the identity of the individual. Data was kept under lock and key and it was accessed by the study staff and the researchers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Not Applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data analyzed during this study is available on reasonable request from the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by the Royal Society of Tropical Medicine and Hygiene (RSTMH) under the RSTMH Early Career Researchers Award – 2024 (id. 36507365). The views expressed herein are those of the authors and not necessarily those of RSTMH. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No author received salary from the funders.\u003c/p\u003e\n\u003cp\u003eFunding was received from The Royal Society of Tropical Medicine and Hygiene (RSTMH) under the early career grants for conducting this study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor’s contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePMA and CT developed and designed the study with guidance from RN. PMA supervised the data collection and the data analysis and drafted the manuscript. PMA, CT and RN carried out the data analysis and writing of manuscript. MM, PK, JT, and MSP played major roles in the conceptualization and design of the study, interpretation of the data and writing of the manuscript. RN critically reviewed and edited the draft manuscript. All the authors read and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank research assistants: Nalunkuuma Aminah, Lwasa Paul, Nakaima Joan, Mudondo Cogra, Bulolo Edward Bossa, and Nabulime Viola. We would like to appreciate Were Edward, the Jinja District Principal Health Inspector, for his support with administrative permission and community entry.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eMuniyandi, M., et al., \u003cem\u003eCatastrophic costs due to tuberculosis in South India: comparison between active and passive case finding.\u003c/em\u003e Transactions of the Royal Society of Tropical Medicine and Hygiene, 2020. \u003cstrong\u003e114\u003c/strong\u003e(3): p. 185-192.\u003c/li\u003e\n\u003cli\u003eWHO, \u003cem\u003eGLOBAL TUBERCULOSIS REPORT 2023.\u003c/em\u003e 2023.\u003c/li\u003e\n\u003cli\u003eWobudeya, E., et al., \u003cem\u003eEpidemiology of tuberculosis in children in Kampala district, Uganda, 2009\u0026ndash;2010; a retrospective cross-sectional study.\u003c/em\u003e BMC public health, 2015. \u003cstrong\u003e15\u003c/strong\u003e: p. 1-8.\u003c/li\u003e\n\u003cli\u003eOrganization, W.H., \u003cem\u003eState of inequality: HIV, tuberculosis and malaria.\u003c/em\u003e 2021.\u003c/li\u003e\n\u003cli\u003eAdeleke, O.A., R.K. 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Davids, \u003cem\u003eDevelopment and evaluation of a reconstitutable dry suspension containing isoniazid for flexible pediatric dosing.\u003c/em\u003e Pharmaceutics, 2020. \u003cstrong\u003e12\u003c/strong\u003e(3): p. 286.\u003c/li\u003e\n\u003cli\u003eMaphalle, L.N., et al., \u003cem\u003ePediatric Tuberculosis Management: A Global Challenge or Breakthrough?\u003c/em\u003e Children, 2022. \u003cstrong\u003e9\u003c/strong\u003e(8): p. 1120.\u003c/li\u003e\n\u003cli\u003eWHO, \u003cem\u003eAdolescent Pregnancy Key Facts.\u003c/em\u003e 2022.\u003c/li\u003e\n\u003cli\u003eWHO, \u003cem\u003eWHO Tuberculosis Key Facts 2022.\u003c/em\u003e 2022.\u003c/li\u003e\n\u003cli\u003eUplekar, M., et al., \u003cem\u003eWHO\u0026apos;s new end TB strategy.\u003c/em\u003e The Lancet, 2015. \u003cstrong\u003e385\u003c/strong\u003e(9979): p. 1799-1801.\u003c/li\u003e\n\u003cli\u003eTanimura, T., et al., \u003cem\u003eFinancial burden for tuberculosis patients in low-and middle-income countries: a systematic review.\u003c/em\u003e European Respiratory Journal, 2014. \u003cstrong\u003e43\u003c/strong\u003e(6): p. 1763-1775.\u003c/li\u003e\n\u003cli\u003eBarter, D.M., et al., \u003cem\u003eTuberculosis and poverty: the contribution of patient costs in sub-Saharan Africa\u0026ndash;a systematic review.\u003c/em\u003e BMC public health, 2012. \u003cstrong\u003e12\u003c/strong\u003e: p. 1-21.\u003c/li\u003e\n\u003cli\u003ePrasanna, T., et al., \u003cem\u003eCatastrophic costs of tuberculosis care: a mixed methods study from Puducherry, India.\u003c/em\u003e Global health action, 2018. \u003cstrong\u003e11\u003c/strong\u003e(1): p. 1477493.\u003c/li\u003e\n\u003cli\u003eMuttamba, W., et al., \u003cem\u003eHouseholds experiencing catastrophic costs due to tuberculosis in Uganda: magnitude and cost drivers.\u003c/em\u003e BMC Public Health, 2020. \u003cstrong\u003e20\u003c/strong\u003e: p. 1-10.\u003c/li\u003e\n\u003cli\u003ePerez-Velez, C.M., C.L. 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S74-S83.\u003c/li\u003e\n\u003cli\u003eShah, K., et al., \u003cem\u003eThe socioeconomic burden of pediatric tuberculosis and role of child-sensitive social protection.\u003c/em\u003e BMC Public Health, 2023. \u003cstrong\u003e23\u003c/strong\u003e(1): p. 2339.\u003c/li\u003e\n\u003cli\u003eWalcott, R.L., et al., \u003cem\u003eThere\u0026rsquo;s no such thing as a free TB diagnosis: Catastrophic TB costs in Urban Uganda.\u003c/em\u003e Global public health, 2020. \u003cstrong\u003e15\u003c/strong\u003e(6): p. 877-888.\u003c/li\u003e\n\u003cli\u003eAtkins, S., et al., \u003cem\u003eThe socioeconomic impact of tuberculosis on children and adolescents: a scoping review and conceptual framework.\u003c/em\u003e BMC Public Health, 2022. \u003cstrong\u003e22\u003c/strong\u003e(1): p. 2153.\u003c/li\u003e\n\u003cli\u003eEkuka, G., et al., \u003cem\u003ePre-diagnostic drop out of presumptive TB patients and its associated factors at Bugembe Health Centre IV in Jinja, Uganda.\u003c/em\u003e African Health Sciences, 2020. \u003cstrong\u003e20\u003c/strong\u003e(2): p. 633-640.\u003c/li\u003e\n\u003cli\u003eWHO, \u003cem\u003eWorld Health Organization Tuberculosis Country Profile: Uganda 2017.\u003c/em\u003e 2018.\u003c/li\u003e\n\u003cli\u003eGovernment, J.L. \u003cem\u003eJinja District Local Government - Economic Activity\u003c/em\u003e. 2025 [cited 2025 25-12-2025]; Available from: https://jinja.go.ug/lg/overview.\u003c/li\u003e\n\u003cli\u003eOrganization, W.H., \u003cem\u003eTuberculosis patient cost surveys: a handbook.\u003c/em\u003e 2017.\u003c/li\u003e\n\u003cli\u003eDe Broucker, G., et al., \u003cem\u003eThe economic burden of measles in children under five in Uganda.\u003c/em\u003e Vaccine: X, 2020. \u003cstrong\u003e6\u003c/strong\u003e: p. 100077.\u003c/li\u003e\n\u003cli\u003eGetachew, N., et al., \u003cem\u003eCatastrophic health expenditure and associated factors among households of non community based health insurance districts, Ilubabor zone, Oromia regional state, southwest Ethiopia.\u003c/em\u003e International Journal for Equity in Health, 2023. \u003cstrong\u003e22\u003c/strong\u003e(1): p. 40.\u003c/li\u003e\n\u003cli\u003eBoU. \u003cem\u003eBank Of Uganda Exchange rates for the United States Dollar (USD)\u003c/em\u003e. 2024 [cited 2024 12-10-2024]; Available from: https://www.bou.or.ug/bouwebsite/ExchangeRates/.\u003c/li\u003e\n\u003cli\u003eMafirakureva, N., et al., \u003cem\u003eHousehold costs incurred when seeking and receiving paediatric tuberculosis services: a survey in Cameroon and Kenya.\u003c/em\u003e Journal of Global Health Reports, 2023. \u003cstrong\u003e7\u003c/strong\u003e: p. e2023071.\u003c/li\u003e\n\u003cli\u003eDatiko, D.G., D. Jerene, and P. Suarez, \u003cem\u003ePatient and health system delay among TB patients in Ethiopia: Nationwide mixed method cross-sectional study.\u003c/em\u003e BMC Public Health, 2020. \u003cstrong\u003e20\u003c/strong\u003e(1): p. 1126.\u003c/li\u003e\n\u003cli\u003eKaswa, M., et al., \u003cem\u003eThe economic burden of TB-affected households in DR Congo.\u003c/em\u003e The International Journal of Tuberculosis and Lung Disease, 2021. \u003cstrong\u003e25\u003c/strong\u003e(11): p. 923-932.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Pediatric-TB, Catastrophic health expenditure, Productivity losses, Costs","lastPublishedDoi":"10.21203/rs.3.rs-9040952/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9040952/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction\u003c/h2\u003e \u003cp\u003eTuberculosis (TB) is an important source of economic devastation, revolving poverty, and illness. It has ensnared families, societies, and even countries globally, with the most vulnerable groups being women, children, and HIV patients. The economic burden of the disease is likely to increase among pediatric TB patients because it affects caregivers. Therefore, we assessed the economic burden faced by households with pediatric and adolescent TB patients aged 0 to 19 years in Jinja district.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe used an incidence-based, ingredient-based approach to estimate societal and household costs which included out-of-pocket costs and lost income incurred during pediatric TB treatment. Catastrophic health expenditures (CHE) were calculated based on the percentage of income spent on TB care among 324 caregivers of pediatric and adolescent TB patients aged 0\u0026ndash;19 years (1st July, 2023 to 30th June, 2024). We used proportionate to size and systematic sampling. Descriptive analysis was used to determine the CHE if it spent more than the following thresholds on pediatric TB management: 10% of its income, 20% of its monthly expenditures or 40% of its monthly expenditures without food.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOut of 324 caregivers, 74.1% were women and 34.0% participants aged 30\u0026ndash;39 years. While TB drugs were provided for free, caregivers incurred an average cost of US \u003cspan\u003e$\u003c/span\u003e 1.42 for diagnosis, US \u003cspan\u003e$\u003c/span\u003e 0.57 for hospitalization, US \u003cspan\u003e$\u003c/span\u003e 2.49 for travel, and US \u003cspan\u003e$\u003c/span\u003e 1.36 for food during treatment. The overall mean cost of TB care per caregiver was US \u003cspan\u003e$\u003c/span\u003e 4.10 excluding food, and US \u003cspan\u003e$\u003c/span\u003e 5.33 with food. In addition to direct costs, caregivers also experienced productivity losses, with a median cost of US \u003cspan\u003e$\u003c/span\u003e 12.97. CHE was experienced by 43.5% households at the 10% income threshold, decreasing to 22.5% and 18.2% at the 25% and 40% thresholds, respectively.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eWhile TB medicines were free at governmental facilities, half of the families caring for children with TB experienced CHE. This increased economic burden on the already financially vulnerable families. Therefore, there is need for social support systems for the caregivers such as offering them with food vouchers.\u003c/p\u003e","manuscriptTitle":"Economic burden of caring for Pediatric Tuberculosis patients among households in Jinja District, Uganda: a cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-08 18:42:06","doi":"10.21203/rs.3.rs-9040952/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-12T15:34:34+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-10T23:18:24+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"145207942840301186761073249839417794506","date":"2026-04-10T15:55:32+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"144768544466635745446744631953318186598","date":"2026-04-10T13:37:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"317364185711276130755719931261106631865","date":"2026-04-06T09:57:49+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-02T09:48:48+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-31T11:48:38+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-10T05:27:27+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-09T12:52:39+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2026-03-09T11:02:25+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"aaea6b88-3ea8-406e-b082-7a601253f08b","owner":[],"postedDate":"April 8th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-08T18:42:06+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-08 18:42:06","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9040952","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9040952","identity":"rs-9040952","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}